Archives: June 2005

Wed Jun 29, 2005

Milwaukee's Columbia St. Mary's Illustrates Nationwide Hospital Building Boom

The proposed $417 million Columbia St. Mary's Hospital in Milwaukee, as reported in the Milwaukee Journal Sentinel, illustrates a nationwide hospital building boom.

According to the Journal Sentinel, a nationwide hospital building boom is underway. During the 1980's and 1990's managed care cost controls and how Medicare paid hospitals caused them to focus on outpatient services rather than new construction.

However, since 2000, a boom has been underway. The paper cites the following factors:


As previously reported, Cincinnati is another city participating in this building boom.

Update: Here is another account of the Columbia St. Mary's project. Note that the new hospital is intended to be "paperless."

Posted by: Duncan Kinder on Jun 29, 05 | 11:46 pm | Profile

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India Promotes Medical Tourism

"A bone marrow transplant in the US costs over $250,000. In India, the bill would hardly cross $26,000. While an uncemented hip surgery in UK would require nearly 10,000, the same would cost not more than 1,500 in India," states the Times of India.

Noting these costs, the Indian tourism ministry is seeking to promote India as a destination for those seeking low cost, high quality medicine. The Times details these efforts.

Posted by: Duncan Kinder on Jun 29, 05 | 8:46 pm | Profile

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Families USA: Petition to Tennessee Governor Phil Bredesen:

Asserting that proposed Tennessee cuts in its TennCare Medicaid program will set a national precedent, Families USA urges people to sign a petition against it.

Petition to Tennessee Governor Phil Bredesen:
Don't Cut TennCare!

As you know, Congress isn't the only battleground in our fight to preserve Medicaid. Several states are considering deep cuts and ambitious restructuring of state Medicaid programs. Perhaps the most critical of these is Tennessee, where Governor Phil Bredesen has proposed the largest cutback of state public health programs in the history of our nation. Gov. Bredesen's plan would strip 323,000 Tennesseans of their health coverage, including 97,000 with chronic conditions and high health care costs. His plan would also saddle 396,000 enrollees, no matter how sick they are, with arbitrary limits on their health care. It is possible--perhaps even likely--that some of these beneficiaries will become sicker, and some may even die, as a result of losing coverage. Click here to read more about Gov. Bredesen's plan (PDF).
http://www.familiesusa.org/site/R?i=2-XsGWWP7xRN_wJlR5xcHA.

But I don't Live in Tennessee--Why Should I Care?

Governor Bredesen has made no secret of his desire to export his vision for destroying Medicaid to the rest of the nation. We have set up an online petition urging Gov. Bredesen to renounce his plan to strip 323,000 Tennesseans of their health coverage. Please sign the petition and forward this e-mail to everyone you know:

Click here to sign the petition
http://www.familiesusa.org/site/R?i=7wkMghw57QA2JheJ3hI4PA.

Why Tennessee Matters

Although several states are considering cutting and "restructuring" Medicaid, Gov. Bredesen's plan to "reform" TennCare (Tennessee's state Medicaid program) is so far the most far-reaching and would do the most harm to a state's Medicaid recipients. Furthermore, Gov. Bredesen is touting his plan as a model for national Medicaid reform. The Governor's vision of national Medicaid reform would impose onerous cost-sharing requirements and arbitrary limits on health care services for beneficiaries, among other things.

Because of Gov. Bredesen's increasingly visible national profile, his actions in Tennessee could have very negative national repercussions for Medicaid. In short, there is a clear danger for national Medicaid reform--as Tennessee goes, so might go the nation. Help us prevent this by signing the petition and forwarding this e-mail:

Click here to sign the petition
http://www.familiesusa.org/site/R?i=D-4g6u5QPHtNy8tTJ8is8w..


More...

Posted by: Duncan Kinder on Jun 29, 05 | 8:17 pm | Profile

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Hearing: Can Tennessee Ration Medicaid Benefits?

A federal district court hearing is beginning today to determine whether the state of Tennessee can effectively ration much of its TennCare Medicaid benefits and regulate what treatment doctors give Medicaid patients. If successful, many believe Tennessee's program could set a precedent for similar public and private coverage plans elsewhere, as reported in The Tennessean.

As previously reported, soaring drug costs have been a major cause of TennCare's financial problems.

Posted by: Duncan Kinder on Jun 29, 05 | 3:19 pm | Profile

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Georgia State Employees to Pay $100 Co-Pays

Soon, Georgia state employees will pay $100 co-pays for some prescription drugs. This is part of a trend by which employers are shifting drug benefit costs to their employees, according to the Wall Street Journal (published by the Pittsburgh Post-Gazette).

Posted by: Duncan Kinder on Jun 29, 05 | 3:03 pm | Profile

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Commonwealth Fund: Baby Boomers Concerned About Their Financial and Health Security, Says Survey

Concerned about their future financial and health security, a substantial majority of older Americans would favor setting aside a portion of their earnings in a special account to save for future medical expenses not covered by Medicare, according to a new Commonwealth Fund survey report released here today.

Sixty-nine percent of a nationally representative sample of 2,000 adults ages 50-70 support dedicating one percent of their earnings to a new Medicare Health Account to help them pay for long-term care services or other uncovered health care expenses. The idea of saving for such an account drew broad-based support among older Americans regardless of income, political affiliation, region of the country, and health status. A strong majority of those ages 50-64 also said they would like to participate in Medicare before they turn age 65.

The Commonwealth Fund Survey of Older Adults shows that a large majority of people in the 50 to 70 age group fear that they will not have enough income and savings to retire and afford needed medical care. Only 15 percent of those ages 50-64 and 22 percent of those between 65 to 70 years felt assured that they would have enough income and savings for retirement. About half (48%) of adults ages 50 to 70 have retirement savings of less than $50,000, and about two of five (38%) have savings of less than $25,000. Retiree benefits are becoming increasingly rare: the majority (53%) of those working or with a working spouse said they would not have job-based retiree health benefits when they retire. This insecurity is eroding confidence: three of five (63%) adults ages 50 to 70 worry that they will not be able to afford medical care in the future.

"It's clear that older Americans are uniformly concerned about their future," says Commonwealth Fund President Karen Davis. "They are anxious for policy solutions that would improve their ability to protect against the high cost of medical care and make it easier to increase their retirement savings," she adds.

Findings from the survey were released today in a new Fund report, Will You Still Need Me? The Health and Financial Security of Older Americans, by Sara Collins, senior program officer at the Fund and colleagues, along with two issue briefs, Paying More For Less: Older Adults in the Individual Insurance Market, and Medicare Health Accounts: A New Policy Option to Help Adults Save for Health Care Expenses Not Covered by Medicare.

More...

Posted by: Duncan Kinder on Jun 29, 05 | 2:36 pm | Profile

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Kaiser Survey: Americans View Medicaid Positively and Are Reluctant to See State and Federal Cuts

Perhaps surprisingly given years of debate about Medicaid, frequent references to the program as the �Pac Man� of state budgets, and periodic calls for reform, public attitudes toward Medicaid are remarkably positive, and opposition to cuts is reasonably strong, according to a new public opinion survey released today by the Kaiser Family Foundation, according to a press release.

While two-thirds of the public think their state has major budget problems, a substantial majority are reluctant to cut Medicaid to balance state budgets, and a majority think the federal government should maintain (44%) or increase (36%) federal spending on Medicaid; only 12% of the public prefer seeing federal funding of Medicaid cut.

Attitudes Towards Medicaid

Nearly three-quarters (74%) of adults say Medicaid is a �very important" government program, ranking it close to Social Security (88%) and Medicare (83%) in the public�s mind, equal to federal aid to public schools (74%), and above defense and military spending (57%). About 8 in 10 Democrats (82%) and Independents (79%) view Medicaid as an important government program, while fewer, but still 6 in 10 Republicans (61%) express that view.

A majority of Americans (56%) report having some interaction with Medicaid, either having been enrolled themselves at some point (16%) or knowing a friend or family member who has received health coverage or long-term care assistance through the program (40%). Additionally, if they needed health care and were eligible, nearly 8 in 10 Americans (78%) say they would be willing to enroll in Medicaid. This view is consistent across different party identifications.

"We expected Medicaid to be relatively unpopular with the public, much like welfare was. But we found that Medicaid ranks closer to popular programs like Medicare and Social Security in the public�s mind. The fact that so many Americans have had some kind of contact with Medicaid themselves or through family and friends is one factor that could help explain this result," said Mollyann Brodie, Ph.D., Vice President and Director of Public Opinion and Media Research for the Foundation. More...

Posted by: Duncan Kinder on Jun 29, 05 | 1:41 pm | Profile

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McKesson Plans to Outsource to India

Pharmaceutical giant McKesson plans to outsource to India, according to Mumbai, India-based Moneycontrol.com. Reportedly it has conducted feasibility studies with large Indian companies.

As previously reported, pharmaceutical companies are also attempting to outsource their R&D.; However, McKesson's goal, reportedly, is to retail Indian-made generics in American stores.

Posted by: Duncan Kinder on Jun 29, 05 | 12:40 am | Profile

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Tue Jun 28, 2005

Why Can't People Hospitals be More Like Animal Hospitals?

Why Can't People Hospitals be More Like Animal Hospitals? Judy Foreman of the Boston Globe wonders why.

Posted by: Duncan Kinder on Jun 28, 05 | 2:55 pm | Profile

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Atlanta Journal Constitution: Put the Non back in Non-Profits

Current IRS definitions distinguishing between "non-profit" and "profit" hospitals are too loose, allowing tax exempt non-profits' executives to enjoy lavish perks, which then are passed onto the patient's, according to the Atlanta Journal-Constitution.

As previously reported, legislators in North Carolina have challenged Blue Cross and Blue Shield of North Carolina's non-profit status because they similarly believe that its executives have enjoyed lavish perks.

Posted by: Duncan Kinder on Jun 28, 05 | 12:16 pm | Profile

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Pharmaceutical Outsourcing: A Growing Trend

Seeking to cut costs: pharmaceutical and biotech companies are increasingly outsourcing their R&D.;

Focusing on Charles River Laboratories, BusinessWeek discusses this trend.


Posted by: Duncan Kinder on Jun 28, 05 | 11:46 am | Profile

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Post-Market Drug Testing: Necessary but Expensive

Following the withdrawal of Vioxx and Bextra because of safety concerns, pressure is on drug manufacturers to improve their product safety. This should make them safer but also would be expensive.

The Winston-Salem (NC) Journal, explores how testing to make drugs safer has become needed yet would be expensive.

Posted by: Duncan Kinder on Jun 28, 05 | 12:04 am | Profile

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Mon Jun 27, 2005

Older Americans are Deferring Retirement in order to Keep Health Benefits

Increasingly, older Americans are deferring retirement because they fear they many loose their health benefits.

The Norfolk Virginian Pilot describes this trend.

Posted by: Duncan Kinder on Jun 27, 05 | 8:50 pm | Profile

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Jackson (TN) Sun: Soaring Drug Costs Hurt Tennessee Health Program

Tennessee is now facing massive cutbacks in its TennCare health care program. Soaring drug costs forced these cutbacks, according to the Jackson (TN) Sun.

Its article, "What Happened To TENNCARE?," details how TennCare's drug costs spiraled out of control.

Posted by: Duncan Kinder on Jun 27, 05 | 3:59 pm | Profile

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Take Two Aspirin and Email Me in the Morning

Once upon a time, doctors were famed for their bedside manners. If Cisco Systems has its way, however, doctors will be treating patients via "E-visits," email exchanges between patients and doctors that can substitute for office visits in certain nonemergency situations, according to InformationWeek.

Cisco wants its employees' insurers to pay for these, the magazine states.

Reportedly, saddled with an aging workforce, Cisco is seeking to cut medical costs.

E-visits would be less expensive than traditional face-to-face visits, Informationweek adds.

Posted by: Duncan Kinder on Jun 27, 05 | 2:09 pm | Profile

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Almost 3,000 Qualified Students Turned Away from Graduate Nursing Programs

According to survey data released on March 8 by the American Association of Colleges of Nursing (AACN), enrollments in entry-level baccalaureate programs in nursing increased by 14.1 percent in fall 2004 over the previous year. This enrollment increase is even greater than AACN's preliminary data released on December 15, 2004 which showed a 10.6 percent increase. Despite this significant gain, more than 32,000 qualified applications were turned away from baccalaureate and graduate nursing programs last year, including almost 3,000 students who could potentially fill faculty roles, according to an AACN news release.

More...

Posted by: Duncan Kinder on Jun 27, 05 | 12:49 am | Profile

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Sun Jun 26, 2005

Health Care Costs as An Educational Issue

Rising costs for healthcare benefits for teachers have made healthcare an educational issue. For example, the Fresno (CA) Unified School District is having a fiscal crisis largely caused by soaring health benefit costs. Unless it can pay its bills, it will face a state takeover. Its permanent superintendent had been ousted and, Chuck McCully, a retired former superintendent was installed to put things in order. His temporary tenure has been a challenge, according to the Fresno Bee.

The Bee describes McCully, the district's problems, and how McCully tackled them.

This is but one example of the growing challenges health costs are making for school districts nationally.

Posted by: Duncan Kinder on Jun 26, 05 | 11:44 pm | Profile

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Teleradiology: Reading CAT Scans Taken In Connecticut from Bangalore

Wide-awake radiologists based in India can provide better service than their sleep-deprived colleagues based in Connecticut, according to Indian physician, Dr Arjun Kalyanpur.

Modern telecommunications have made possible the "global hospital," he states. Diagnoses can be made on the other side of the world.

He adds that nighttime emergencies in the United States can be better handled by wide-awake Indian doctors, where it would then be daytime, than by their sleep-disturbed American counterparts.

Posted by: Duncan Kinder on Jun 26, 05 | 3:00 pm | Profile

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Offshoring Nursing Schools

Responding to the nursing shortage in the United States and elsewhere, the Ross University International School of Nursing opened June 15 on St. Kitts in the Caribbean, according to the St. Kitts & Nevis Democrat.

As previously reported, in the United States a shortage in nursing faculty is causing, in turn, an overall shortage of nurses.

Reportedly, the school will have 1,500 students, who will train for a year in St. Kitts and then travel to the United States for twenty-four weeks of clinical work at affiliated U.S. colleges.

Posted by: Duncan Kinder on Jun 26, 05 | 2:29 pm | Profile

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Sat Jun 25, 2005

Book Review: The Rise and Fall of HMOs

Jan Gregoire Coombs'The Rise and Fall of HMOs : An American Health Care Revolution describes how the HMO, intended to control medical costs, found that the most profitable means to do so was to deny service. Her broad overview of the HMO combines with a focus on the Marshfield Clinic in northern Wisconsin, which she uses to illustrate her points.The Marshfield, WI, Marshfield News Herald interviews her. Amazon.com also has reviews.




The Rise and Fall of HMOs : An American Health Care Revolution

Posted by: Duncan Kinder on Jun 25, 05 | 12:30 pm | Profile

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The Hard Life of Rural Doctors

Long hours, (relatively) low pay, and restricted social life discourage doctors from working in rural areas.

The Eureka,CA, Times-Standard describes how the strains of rural practice make it difficult to attract and retain doctors in Del Norte County, California.

Posted by: Duncan Kinder on Jun 25, 05 | 11:15 am | Profile

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Fri Jun 24, 2005

Kansas City, MO, Tops List of Most Affordable Cities for Health Insurance

The first national report on the largest cities in the U.S. with the most affordable health insurance options for families was released by eHealthInsurance, an online health insurance source for individuals and families, according to a press release.

The cities at the top of the list of Most Affordable Cities are:

  1. Kansas City, MO;
  2. Long Beach, CA;
  3. Columbus, OH;
  4. (tie) Tucson and Mesa, AZ;
  5. (tie) San Francisco, Oakland, San Jose, Fresno and Sacramento, CA;
  6. Omaha, NE;
  7. San Diego, CA;
  8. Cleveland, OH;
  9. Phoenix, AZ; and
  10. Los Angeles, CA.


The premiums quoted for a four-member family plan in these cities ranged from $172 to $212 per month.

A key trait shared by cities with the most affordable health insurance is the large number of health insurance options available for families. The top-ranked cities have at least 43 plans available on eHealthInsurance.com, enabling consumers to choose from a large number of the health insurance plans available to them.

"Choice of health insurance options can allow families to find and buy the right plan at a cost they can afford," said Gary Lauer, CEO of eHealthInsurance. "This report confirms that affordable health plans with very good benefits are available for families purchasing health insurance across much of the country."

Health insurance plans used in these rankings feature comprehensive benefits, including annual preventive exams, lab and x-ray services, emergency room treatment and hospitalization.

eHealthInsurance ranked the affordability of family health insurance options in the nation's 50 largest cities, as defined by the U.S. Census Bureau. The health insurance plans reviewed are the least expensive available in each city through www.ehealthinsurance.com for a non-smoking family of four, including two parents (ages 35 and 37) and two children (ages 9 and 11). Each plan includes an annual deductible of no more than $2,000 in addition to 20% coinsurance, which is the amount the policyholder pays for medical services once the deductible is met. Additionally, each plan reviewed had a maximum per-family out-of-pocket cost of between $4,000 and $10,000 per year.

Posted by: Duncan Kinder on Jun 24, 05 | 11:03 am | Profile

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Canadians Continue Push to Limit Drug Exports to USA

Canada will soon announce measures to limit the export of its drugs to the United States, according to the Chicago Tribune.

As previously reported, many Canadians oppose United States' importing less expensive drugs from Canada because they believe it may disrupt Canada's own system.

Posted by: Duncan Kinder on Jun 24, 05 | 10:36 am | Profile

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Do 43 or 62 Percent of Companies Have Wellness Programs?

According to a survey by by Aon Consulting, "43 percent of the companies surveyed have adopted a formalized disease management and health promotion/wellness strategy for employees. Another 19 percent have been asked by senior management to explore opportunities associated with these programs."

However, as recently reported, a survey by the Deloitte Center for Health Solutions of 365 of the nation�s leading companies found that 62 percent of companies said they implemented wellness programs to improve employee health, and another 33 percent said they were considering such programs. Of those companies with programs, 64 percent said rising health care costs were �a major factor in our decision� and another 34 percent said high costs played some role.

Posted by: Duncan Kinder on Jun 24, 05 | 12:03 am | Profile

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Thu Jun 23, 2005

Vermont: Governor Vetoes Single Payer Plan

Vermont's governor Gov. James Douglas, in a move applauded by America's Health Insurance Plans, on Wednesday vetoed the Legislature's single payer health bill, H.524.

Douglas, who reportedly had objected to the bill's payroll tax provisions, cited 23 different objections in his veto message,:



The press release does not disclose what health coverage Governor Davis himself has.

Posted by: Duncan Kinder on Jun 23, 05 | 8:27 pm | Profile

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The Deming Approach to Medical Quality

Comment: Kevin Drum has been discussing how anesthesiologists are achieving lower malpractice rates through improving their overall safety, Drum asserts "Still, if doctors and insurance companies spent half as much time trying to reduce medical errors as they did trying to rig the legal system in their favor, they might save lives and reduce malpractice premiums. I don't really expect insurance companies to care much about this, but doctors ought to."

This sounds like a lovely rationale for more lawsuits and more lawyers.

The capacity for rank hypocrisy amongst all sides of the malpractice debate is simply amazing. Look at Canada. Many people who want single-payer point to Canada's medical system. Yet they conveniently forget that Canada also has a looser-pays tort system. Sue a doctor for malpractice and loose and you must compensate him for the time and trouble you have cost him. You, too, have responsibilities. Meanwhile, tort reform advocates, who advocate Canada's looser pays system, conveniently forget Canada's single-payer and other social welfare nets. The Canadian health system is not perfect; so let's continue to study the matter while millions go uninsured and health costs soar, they say.

Each side points out the other's flaws while ignoring its own.

This is ridiculous.

One way to steer our way out of this situation is the Deming style of management. This would be a systems approach, which apparently the anesthesiologists have been following. We would strive, not for immediate perfection but rather for continuous improvement.

This means that imperfections are not to be denied - which perfection would demand - but rather to be sought out and cured. It is not about placing blame but fixing problems.


Posted by: Duncan Kinder on Jun 23, 05 | 1:41 pm | Profile

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AARP: Europe's Drug Importation Program is Safe

While American's debate whether drugs should be imported from abroad, the American Association of Retired Persons (AARP) has released a study of the European program that allows drugs to be imported and has found it to be safe.

According to AARP's news release:


Posted by: Duncan Kinder on Jun 23, 05 | 1:04 am | Profile

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Federally Qualified Health Centers: One Option for the Uninsured

One option the uninsured do have is federally qualified health centers. The Battle Creek (MI) Enquirer describes how its community hopes to use such a center to care for the uninsured.

Posted by: Duncan Kinder on Jun 23, 05 | 12:24 am | Profile

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Wed Jun 22, 2005

Survey: 83 Percent of Employers Increased the Amount of Money Employees Contribute to Their Own Healthcare Coverage in the Last Year.

Eighty-three percent of employers surveyed increased the amount of money employees contribute to their own health care coverage in the last year, according to a release issued by the Deloitte Center for Health Solutions. Another 30 percent said they had introduced consumer-directed health options, such as flexible spending accounts.

Businesses are also increasingly turning to wellness programs to get a handle on rising health care costs, and most believe these programs will have a long-term impact but few short-term benefits, according to a survey released today by the Deloitte Center for Health Solutions and the ERISA Industry Committee (ERIC).

More...

Posted by: Duncan Kinder on Jun 22, 05 | 11:49 pm | Profile

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Maryland's Proposed Medicaid Cuts Would Affect Immigrants

Maryland Governor Robert L. Ehrlich Jr.'s proposed budget would eliminate a $7 million dollar program for low-income pregnant women and children who are legal permanent residents, according to the Baltimore Sun.

As we previously reported, immigrants are more likely to uninsured than are the native born.

Posted by: Duncan Kinder on Jun 22, 05 | 11:30 pm | Profile

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Specialty Hospitals: Kansas City Experiencing Conflict Between Specialty and Traditional Hospitals

The conflict we previously have reported between specialty hospitals and traditional hospitals is heating up in Kansas City, according to theKansas City Star.

Specialty hospitals, unlike traditional hospitals, focus on one field, such as cardiology, orthopedics, surgery and women's care. Typically they are doctor owned.

Specialty hospitals are usually smaller, have a lower doctor-to-patient ratio and usually offer higher quality customer service than other hospitals. However, because they are doctor-owned, they can create conflicts of interest.

Currently, making new specialty hospitals is under a moratorium.

Senators Max Baucus (D., Montana) and Charles Grassley (R. Iowa) have introduced a bill intended to make this moratorium permanent.

Meanwhile, both the Kansas and Missouri legislatures are also studying the issue, the Star reports.

Posted by: Duncan Kinder on Jun 22, 05 | 2:36 pm | Profile

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Big Pharma Firm Seeks to Make Biotech Drugs Less Expensive

Pharmaceutical giant Wyeth has teamed with Dublin City University (Ireland) in a project to find ways to make genetically engineered drugs less expensive.

As we previously have reported, biotech drugs pose a challenge to big pharma because, unlike traditional pills and liquids, they are expensive to produce and not easily taken.

This project was funded by a 4 million euro grant from the Science Foundation of Ireland. "Wyeth's commitment to the project will be comparable to that underwritten by SFI," the report of this project adds.

"This new research is intended to facilitate breakthroughs in the yield of therapeutic proteins produced in mammalian cell culture based manufacturing processes," the report states. In other words, it seeks to boost the productivity of cell cultures.






Posted by: Duncan Kinder on Jun 22, 05 | 2:36 pm | Profile

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Anesthesiologists Get Lower Malpractice Rates by Improving Patient Safety

Unlike other doctors, anesthesiologists responded to malpractice pressures, not by pushing for malpractice caps, but rather by improving patient safety. Result: they pay lower premiums today, in constant dollars, than they did twenty years ago, according to the Wall Street Journal. (as printed in the Pittsburgh Post-Gazette.)

Posted by: Duncan Kinder on Jun 22, 05 | 1:49 pm | Profile

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Massachusetts: Governor Proposes Penalties for Those Lacking Insurance

Massachusetts Governor Mitt Romney proposed today that individuals who fail to obtain medical insurance face penalties, according to the Boston Globe.

Many people who could obtain health insurance currently choose not to do so.

Romney's proposed "individual mandate," is part of his broader proposed health care reform package for the state.


Posted by: Duncan Kinder on Jun 22, 05 | 11:30 am | Profile

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Too Few Nursing Faculty is Causing a Nursing Shortage

It is getting harder and harder to find nurses. And this will not end soon, because nursing schools lack the faculty to meet the rising demand.

The Orlando Sentinel, in "Teachers needed for nursing shortage Lack of programs and faculty hampers training of nurses," explores how this shortage is affecting healthcare.

Posted by: Duncan Kinder on Jun 22, 05 | 1:15 am | Profile

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Tue Jun 21, 2005

Study: Costs Per Privately Insured American Grew 8.2 Pecent: Virtually the Same Rate of Increase as in 2003

The reprieve from faster-growing health care costs stalled in 2004 as costs per privately insured American grew 8.2 percent�virtually the same rate of increase as in 2003, according to a study by the Center for Studying Health System Change (HSC) published today as a Web-exclusive article in the journal Health Affairs.

Health spending growth continued to outpace overall economic growth by a wide margin�2.6 percentage points�in 2004, despite a robust 5.6 percent increase in the overall U.S. economy as measured by per capita gross domestic product, the study found. After peaking at 11.3 percent in 2001, health care spending growth slowed in 2002 and 2003 but now has leveled off at a relatively high rate.

"If health care spending continues to grow at a significantly faster rate than workers' incomes�and there's every sign that it will�health insurance will become unaffordable to more and more people," said Paul B. Ginsburg, Ph.D., coauthor of the Health Affairs study and president of HSC, a nonpartisan policy research organization funded principally by The Robert Wood Johnson Foundation.

Although underlying health spending growth stabilized, the slowdown in employer-sponsored health insurance premium growth continued. In 2005, estimated average premium increases ranged from 8 percent to 10 percent, down from an average 12 percent in 2004.

For the fourth year in a row�although to a lesser degree than in recent years�employers in 2005 increased patient cost sharing, through higher deductibles, copayments and coinsurance, as a way to cope with high premium increases.

"Employers appear either to have reached what they consider the limits of acceptable patient cost sharing or to feel less pressure to shift costs to employees in light of the improving economy and recent decline in the premium trend," said Bradley C. Strunk, an HSC researcher and study coauthor, along with John P. Cookson of Milliman Inc.

Trends in four of the five spending categories�inpatient and outpatient hospital care, physician services, and other services�stabilized in 2004, while prescription drug spending grew at a slower rate for the fifth year in a row. Key findings include:

Prescription drug spending per privately insured person increased at a slower pace, growing 7.2 percent in 2004�compared with 8.9 percent in 2003 and less than half the 1999 peak increase of 18.1 percent. The slowdown in 2004 was largely a result of slower growth in drug prices (3.3%) rather than changes in the growth of drug utilization (3.8%). Prescription drug spending accounted for 21 percent of the overall total spending increase in 2004.

Spending on inpatient hospital services increased 6.2 percent in 2004, essentially unchanged from the 6.1 percent increase in 2003. Spending on outpatient care increased 11.3 percent�keeping it the fastest growing category of health spending for the fourth year in a row�compared with 11.1 percent in 2003. The outpatient hospital category includes spending for services provided in freestanding facilities, such as surgery centers and imaging centers. Taken together, spending growth on inpatient and outpatient care accounted for 54 percent of the total increase in health spending in 2004.

After slowing sharply in 2003, the hospital utilization trend increased somewhat in 2004, growing 2.9 percent. But hospital price growth�for inpatient and outpatient care combined�slowed for the first time in seven years in 2004, albeit at a relatively high rate of 7 percent.
Spending on physician care increased 6.4 percent in 2004, identical to the 2003 growth rate. There was a small decline in the growth rate for use of physician services, while growth in prices for physician services increased slightly. Growth in spending on physician services accounted for 24 percent of the total increase in spending growth

Spending on other types of services-most notably home health care and ambulance services-grew 6 percent in 2004 and accounted for about 2 percent of the overall increase in spending growth.

The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nation's changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded principally by The Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.

Health Affairs, published by Project HOPE, is a journal of health policy.

Posted by: Duncan Kinder on Jun 21, 05 | 2:46 pm | Profile

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The Biotech Challenge to Big Pharma

Big Pharma may find new biotech medicines tough to swallow, according to the Kansas City Star. Unlike Big Pharma's traditional pills and liquids, new biotech products must inhaled or injected.

The paper states that traditionally drug firms turned chemicals into pills and liquids that were easy to mass produce and to market.

However, it adds, biotech makes drugs from genes and organism, which are costly to produce and difficult to market because they must be inhaled or injected.

This difference poses an economic challenge for both big pharma and for biotech companies.

The rest of the article details what these challenges are and how both might meet these challenges.

Posted by: Duncan Kinder on Jun 21, 05 | 1:21 pm | Profile

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UC Davis Provides Experts on Healthcare

The University of California at Davis states that its faculty has a broad expertise regarding health and nutrition in regards to poverty. Spanish-language media members, please note those on the list who are fluent Spanish speakers. If you need information on a topic not listed, please contact UC Davis Health System Public Affairs, (916) 734-9040; Pat Bailey, UC Davis News Service, (530) 752-9843, [email protected]; or Susanne Rockwell, UC Davis News Service, (530) 752-9841, [email protected]

Areas of expertise include:

GENERAL HEALTH ISSUES


NUTRITION

FAMILIES AND CHILDREN

ETHNIC AND IMMIGRANT HEALTH

Posted by: Duncan Kinder on Jun 21, 05 | 12:50 pm | Profile

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Massachusetts: Governor Mitt Romney Advocates His Health Care Reform Package

Massachusetts Governor Mitt Romney advocated his plan to promote affordable private medical insurance for residents of the state in the Boston Herald on June 21.

According to Romney, "My approach is based on several principles. First, private insurance is better, cheaper and more efficient than a government-run health-care scheme. Second, everyone has a responsibility to have health insurance; for those who cannot afford it, government will help, but only to the extent needed - not as an entitlement. Third, government has roles to play in helping all citizens become insured, from expanding consumer choice to creating incentives and tax benefits."

Romney cites no evidence that "private insurance is better, cheaper and more efficient" nor does he explain how government-run systems are a "scheme".

In a press release Romney's office states, "Approximately seven percent, or 460,000, of Bay State residents currently do not have health insurance. Of those, 168,000 have household incomes greater than 300 percent of the federal poverty level and should be able to purchase some form of health insurance. Many of these individuals are employed by small businesses that either do not offer health insurance, or they are part-time or contract workers not eligible for benefits through their job."

The press release does not discuss individuals who have been denied health insurance through "medical underwriting,� the process whereby insurers screen out applicants because of their health.

The release states: "Romney�s legislation will enable private insurers to offer a comprehensive health insurance product costing approximately $200 a month, compared to the current $350 average cost for small group products and over $500 average for non-group products. This will provide small businesses and individuals without insurance expanded choice at a lower cost.�

It adds, �The new insurance plans, developed by the private insurance companies, will be high quality and offer the following categories of coverage:


Romney�s bill establishes a new entity, the Commonwealth Care Exchange, to facilitate the pre-tax payment of premiums by working individuals, resulting in a 15 to 30 percent savings off their insurance bill depending on income. Using pre-tax dollars will enable working individuals to purchase the new plans for an effective cost of between $134 and $160 a month.

The new exchange will also enable, but not require, a participant�s company to make a financial contribution toward their healthcare costs.

To encourage participation in the exchange, Romney�s plan offers incentive payments to companies for registering. In addition, the state will provide decals to companies that offer health insurance to their employees so they can publicize their good corporate citizenship.

A nine-member board will govern the Commonwealth Care Exchange...."

"Another 36,000 unemployed individuals are also expected to take advantage of the new low-cost insurance products," it adds.

Romney's program also includes signing up those eligible for Medicaid who are not currently enrolled.

It would also include "Safety Net Care, which will convert the uncompensated care pool into an insurance plan for the 150,000 working poor and long-term unemployed, directing them to a specified network of clinics, community health centers and hospitals."

In his Boston Herald column, Romney states that his plan includes a "personal responsibility principle." Everyone who can get insurance or pay for his healthcare, should.



Posted by: Duncan Kinder on Jun 21, 05 | 10:10 am | Profile

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Mon Jun 20, 2005

Welcome to the Proletariat, Doctors

Soaring office costs and shrinking pay from insurers is forcing more and more doctors to abandon private practice and, instead, to become employees of corporations.

The Miami Herald discusses what this trend might mean.

Apparently this is a nationwide trend. For example, approximately one-tenth of the 2,358 practicing doctors in Jefferson County are now no longer in independent practice but rather employed by a hospital.

Posted by: Duncan Kinder on Jun 20, 05 | 3:02 pm | Profile

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AMA Survey Finds Next Generation of Physicians Plagued by Sleep Deprivation

Many medical students and residents in hospitals across the country are plagued by sleep deprivation and fatigue, according a new American Medical Association (AMA) member survey released on June 17.

The survey was conducted to determine what effect resident duty hour requirements, implemented by the Accreditation Council for Graduated Medical Education (ACGME) in July 2003, are having on medical students and resident physicians. According to the ACGME, resident physicians may not work more than 80 hours per week and on-site duty cannot exceed 24 consecutive hours (there are no national specific hour restriction guidelines for medical students).

"This valuable information tells us that too many of our medical students and residents are tired and sleep deprived, and they feel that it can effect the quality of their education and training," said AMA Board of Trustees Chair J. James Rohack, MD. "We must curb excessive duty hours, while at the same time ensuring the highest quality of patient care."

Approximately 44 percent of residents and 39 percent of medical students reported that they experienced periods of prolonged sleep deprivation about once a week or more often during their most recently completed rotation. The survey also found that 11 percent of residents and 12 percent of students worked more than 80 hours per week on their most recently completed rotation.

Key findings include:

The survey was conducted as part of the AMA's Member Connect� program and included responses from 1,126 medical students and 1,010 resident physicians. A complete overview of the findings is available online.

Posted by: Duncan Kinder on Jun 20, 05 | 2:44 pm | Profile

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South Carolina to Require Health Insurance Plans to Cover Mental Illness

South Carolina, effective June 30, will require health insurance plans to cover mental illness in S49, which the state's General Assembly passed on Mays 12, and became law on May 25 without the governor's signature.

According to the bill, "A health insurance plan must provide coverage for treatment of a mental health condition and may not establish a rate, term, or condition that places a greater financial burden on an insured for access to treatment for a mental health condition than for access to treatment for a physical health condition in similar settings and treatment modalities."

However, the bill does not "require a health insurance plan to provide rates, terms, or conditions for access to treatment for mental illness that are identical to rates, terms, or conditions for access to treatment for a physical condition."

Apparently, therefore, the rates, terms, and conditions for mental illness may differ from physical condition coverage so long as they do not place a greater financial burden in similar settings and treatment modalities. What this means is unclear.

The bill also makes special provisions for managed care and for the state department of insurance to report to the legislature about what impact this bill is having.

Posted by: Duncan Kinder on Jun 20, 05 | 2:01 pm | Profile

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Hospital Boom in Cincinnati

Greater Cincinnati and Northern Kentucky are experiencing a $700 million hospital building boom, according to the Cincinnati Enquirer..

According to the Enquirer, this building boom is taking place in the suburbs and not the center city.

In healthcare, unlike most other economic sectors, more hospitals can mean greater costs not lower costs, the paper adds.

Posted by: Duncan Kinder on Jun 20, 05 | 12:39 am | Profile

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Sun Jun 19, 2005

Cancer Center Spurs Economic Development Efforts in Tampa Bay

The University of South Florida's Tampa campus-based H. Lee Moffitt Cancer Center & Research Institute is attempting to partner with four major pharmaceutical companies, thereby boosting the Tampa area economy, according to the Tampa Tribune.

If successful, Moffitt's cancer research should boost Tampa's local economy much as cancer research is now boosting Philadelphia's.

Posted by: Duncan Kinder on Jun 19, 05 | 1:25 pm | Profile

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Sat Jun 18, 2005

What Do We Pay Doctors to Do?

Challenging many widely held assumptions about health care, Arnold Kling argues that doctors should be paid - not for their results, not for their efforts, and not per patient - but rather for their adhering to prescribed treatment guidelines.

According to Kling, there are four possible methods to pay doctors:

Kling argues that capitation creates the medical rationing that recently caused the Canadian Supreme Court to strike down provisions of the Quebec medical system . Paying doctors on outcomes will not work because too many factors are beyond their control, he adds.

Rewarding on effort is the current American system, which he characterizes as "activist medicine" in another article. Activist medicine is the tendency to pour greater and greater amounts of effort into medical treatment in return for questionable added medical benefits.

This activist approach, he argues, is what makes the American healthcare system so expensive.

He concludes that paying on guidelines should therefore be considered. Some outside expert board should establish treatments for illnesses which doctors should follow.

Of course, it would be no small trick to set up uniform medical guidelines. Nor would it be easy to change them, once they were put in place. Look at how difficult it has been to change America to the metric system of measurement. Imagine some effort to establish a rational system of English spelling. Try, just try, to simplify the tax code. Similar problems would plague any effort to modify uniform medical standards.

Still, Kling is a clear, original thinker and a good writer. He should be read by anyone wanting to increase his understanding of how and why the American medical system is the way it now is.

Posted by: Duncan Kinder on Jun 18, 05 | 10:33 am | Profile

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Fri Jun 17, 2005

Clinton, Frist Introduce Bill To Establish Health Information Standards

Citing a need to "reduce costs, enhance efficiency and improve overall patient care," in the American medical system, Senators Hillary Clinton and William Frist introduced the "Health Technology to Enhance Quality Act of 2005" on June 16. The act seeks to create uniform standards for electronic health information systems to talk to one another.

The legislation codifies the Office of National Coordinator for Information Technology and establishes standards for the electronic exchange of health information. The bill also authorizes grants to local and regional consortiums to implement health information technology infrastructure that is compliant with national standards and establishes measures to assess the quality of care. Finally, it establishes standard quality measures to better assess the value of federal programs.

The basic points of the act are as follows:
Title I: Health Information Technology Standards and Infrastructure Development

Title II: Encouraging Use of Interoperable Health Information Systems Title III: Adoption, Implementation, and Use of Health Care Quality Measures A more detailed description of the bill is available. While, Clinton, Frist, and others have advocated electronic medical records as a means to promote medical quality; others have cited privacy risks as a problem these records pose.

Posted by: Duncan Kinder on Jun 17, 05 | 1:43 pm | Profile

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Ohio's Non-Profit Hospitals: Charities or Profit-Seeking Enterprises?

Ohio's non-profit hospitals received $898 million in tax breaks but spent only $219 million in uncompensated care, according to a report issued by The Service Employees International Union District 1199..

According to the report, "Too little is known about hospital policies and finances. Hospitals are subject to only minimal reporting requirements, and the laws governing charitable tax exemptions are vague. So when hospitals publicly justify their tax breaks with their own inflated estimates of the value of the benefits they provide their communities, taxpayers have little information with which to discern the truth."

The report concludes that hospitals should annually disclose their:

According to the report, Ohio's hospitals are now a $21 billion a year industry - now the third largest private employer in the state.

They have now merged into large systems. Ninety-two percent of all Ohio hospitals are now part of a network.

Although officially non-profit, they earned $940 million in profits in 2003.

Posted by: Duncan Kinder on Jun 17, 05 | 12:44 am | Profile

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Thu Jun 16, 2005

Wisconsin Health Proposal: Allow All State Residents to Buy Health Insurance as is Now Done in the State Employee Plan

Two Wisconsin legislators on June 15 introduced a proposal to allow all state residents to buy health insurance as the state now does in its employee plan.

This �Wisconsin Health Plan� proposes a new way to pay for health care in Wisconsin. The new
proposal has three components:

� All Wisconsin employers pay a fair assessment;
� All Wisconsin residents (under age 65) own a Health Insurance Purchasing Account;
� All participants have an annual choice of health care plans and providers.

Two legislators, Rep. Curt Gielow (R-Mequon) and Rep. Jon Richards (D-Milwaukee) announced on June 15 a health care reform initiative which seeks to address Wisconsin�s �triple crisis� in health care: the skyrocketing cost of health care, increasing numbers of uninsured, and the ever-present deficit in the state�s Medicaid program. If adopted, the plan could free up nearly $1 billion in state revenues over the biennium for tax cuts and other needed investments.

David Riemer, Director of the Wisconsin Health Project, outlined the details of the reform proposal before the Assembly Medicaid Reform Committee on June 15.

Rep. Gielow, chair of the Assembly Medicaid Reform Committee said, �The Medicaid program is suffering from a mammoth, recurring structural deficit because costs and caseloads are rising much faster than state revenues. The state has relied on short-term fixes to get by thus far, but the severity of the situation continues to undermine our other state priorities. This proposal aims to relieve pressures on the state budget stemming from the Medicaid and BadgerCare programs.�

�Each year, up to 500,000 Wisconsinites have no insurance coverage and the number is
increasing,� said Rep. Richards. �Wisconsin has historically been a national leader in this area, but one-half million uninsured residents is simply unacceptable. Under this proposal, all Wisconsinites under age 65 will be covered.�

Wisconsin employers now spend an average of 15% of payroll for the health care premiums of their employees.

�Wisconsin employers are experiencing double-digit percent increases in the cost of
health care each year,� said Gielow. �The result is an adverse economic effect on wages, profits, job creation, and new investment in Wisconsin.�

�This proposal replicates the successful experience the state employment system has had in
controlling its health care costs,� said Richards. �Our plan will allow all state residents to buy health nsurance as we do in the state employee plan.�


Through the creation of an effective purchasing pool and �consumer driven� incentives, the proposal aims to promote health care quality and use market forces to drive down health care costs. The details of the plan are outlined in the attached Concept Paper.

Posted by: Duncan Kinder on Jun 16, 05 | 10:20 am | Profile

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Leading Indian Doctor Proposes Two Tier Health System for America

Dr. Naresh Trehan, former president of the International Society of Minimally Invasive Cardiothoracic Surgery (ISMICS) and founder of the internationally renowned Escorts Heart Institute and Research Center (EHIRC) in New Delhi, has proposed a two-tier health insurance system for the United States.

He says he has submitted his proposal to Senator Hillary Clinton.

According to Trehan, American healthcare has become too expensive. "Unless they regulate it Americans can't afford healthcare," he said.

He says he as proposed a two-tier system. The first tier, an expensive $10,000 policy would insure for everything one needed from sources in the United States. Tier Two, however, a less expensive $5,000 policy, would provide emergency care in the United States but would provide a menu of certified facilities around the world.

Posted by: Duncan Kinder on Jun 16, 05 | 1:07 am | Profile

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Wed Jun 15, 2005

Drug Company Marketing: A Sceptical Look

For an eye-opening discussion of marketing by drug companies, read "Pill Poppers Doctors just say no to drug company hype and freebies" by Ted McDonough in Salt Lake City Weekly

For a flavor of what McDonough has to say:

"Among the most startling aspects of Vioxx to anyone who has seen television commercials for the drug is that while it is one of the best-selling medications for arthritis�$1.3 billion in 2004�it has never been proven any better than aspirin at relieving pain. The drug�s maker never claimed it was�at least not in the medical literature�where its benefit was given as a lower incidence of ulcers."

Posted by: Duncan Kinder on Jun 15, 05 | 11:58 pm | Profile

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Specialty Hospitals: An Emerging Issue

Specialty hospitals - hospitals that focus on one field, such as cardiology, orthopedics, surgery and women's care - are an emerging challenge to traditional hospitals. Typically, they are doctor-owned.

Currently a moratorium exists on new specialty hospitals.

The Sioux Falls Argus Leader in "Specialty hospitals Investigate whether facilities are to the benefit of doctors or patients," explores the problems and opportunities specialty hospitals would pose.

According to the paper, specialty hospitals are usually smaller, have a lower doctor-to-patient ratio and usually offer higher quality customer service than other hospitals. However, because they are doctor-owned, they can create conflicts of interest.

The Argus Leader provides an overview of the current debate regarding specialty hospitals. It omits - as does the current debate - an important point. Many of the procedures specialty hospitals in the United States would do could also be done - through medical tourism - at much lower cost in India, Thailand, or Singapore. Therefore, they may experience price competition that would make them much less profitable than their owners now hope.

Posted by: Duncan Kinder on Jun 15, 05 | 11:58 pm | Profile

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Cancer Research and Philadelphia's Economy

According to The Philadelphia Daily News, "High-end cancer research has quietly become one of Philadelphia's most important - and lucrative - industries, attracting top doctors and scientists to the region and pouring hundreds of millions of research dollars into the economy yearly."

It's article, Can Philly Cure Cancer?, by Michael Hinkelman, treats the city's cancer research as an economic development issue.

Posted by: Duncan Kinder on Jun 15, 05 | 11:58 pm | Profile

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Most "Canadian Pharmacy" Websites Are Bogus

Of approximately 11,000 websites designed to appear to be Canadian pharmacy sites, only 214 appear actually to be so, according to research done at the request of the U.S. Food and Drug Administration (FDA) by Cyveillance.

According to Cyveillance, only 1009 of these 11,000 sites actually sold prescription drugs. Of these 1009, only 214 had registration data indicating that the site's owner lived in Canada or were hosted by a Canadian internet service provider.

"Certain patterns emerged as well from analysis of the fraudulent sites, for example the fact that over half of the sites registered in the United States and dispensing drugs were registered to a single firm," Cyveillance stated.

Cyveillance is a company providing online risk monitoring and management solutions

Posted by: Duncan Kinder on Jun 15, 05 | 2:04 pm | Profile

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Elderly Americans Less Willing to Sacrifice Health Care Choice for Lower Costs than are Working-Age Americans

Elderly Americans are much less willing than working-age Americans to limit their choice of physicians and hospitals to save on out-of-pocket medical costs, according to findings from a new national study by the Center for Studying Health System Change (HSC).

In 2003, only 45 percent of seniors 65 and older were willing to trade broad provider choice to save money, compared with 70 percent of people aged 18 through 34, the study found.

"In fact, elderly Americans represent the only age group where a majority does not favor giving up provider choice to save on out-of-pocket costs," the study stated.

The higher their income, the more likely the elderly would prefer choice and reject lower costs as a trade off, the report added.

The Center for Studying Health System Change is a nonpartisan policy research organization

Posted by: Duncan Kinder on Jun 15, 05 | 2:04 pm | Profile

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Tue Jun 14, 2005

Study: Immigrants are More Likely to Be Uninsured

Your likelihood of being uninsured in 2003 was 47.1 percent if you were foreign born not a citizen but only 14.7 percent if you were native born, according to a report issued this June by the Employee Benefit Research Institute.

The likeliood for native children with two foreign born parents was 17.8 percent; for foreign born naturalized it was 21.2 percent, the report added.

Native born Americans do account for most of the uninsured, it stated. 33 million of the 44.7 million uninsured were native born. However, the likelihood of being uninsured is increasing for immigrants while remaining stable for the native born.

According to the report, the longer an immigrant has resided in the United States, the more likely he is to be insured. The chance of being uninsured rises as follows:

Decade: Percent
Before 197021.4
1970-197936.2
1980-198943.0
1990-199947.4
2000-200453.4


The uninsured immigrant population mostly resides in four states: California, Texas, New York, and Florida. Statewide breakdown is as follows:

StatePercentage Number (Millions)
Total10011.6
California273.2
Texas151.7
New York101.1
Florida91
Illinois40.4
New Jersey40.4
Arizona30.4
North Carolina30.3
Maryland20.3
Georgia20.2
Washington20.2
Virginia20.2
Colorado20.2
Massachusetts20.2
Oregon10.2
Ohio10.1
Nevada10.1
Pennsylvania10.1
Other States101.2

Posted by: Duncan Kinder on Jun 14, 05 | 3:57 pm | Profile

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Specialty Drug's Price Increases Outpace General Drugs

Specialty Drug's Price Increases Outpace General Drugs The price of specialty drugs - generally biotech drugs used for such illnesses as anemia, rheumatoid arthritis, cancer, and multiple sclerosis - are rising 22.5 percent, according to a survey released on June 13 by Aon Consulting. General drugs, in contrast, are rising 13.1 percent, Aon added.

According to Aon, specialty pharmacy includes high cost pharmaceutical products that are generally, but not exclusively, biotech in nature. Most require injection or other unique methods of administration and refrigeration or special handling. Conditions most commonly treated by specialty pharmaceuticals include anemia/neutropenia, rheumatoid arthritis, cancer, multiple sclerosis. The annual per patient cost of these drugs can range from $10,000 � $250,000.

Specialty medications carry significantly higher costs than traditional drug products taken by mouth. They currently represent about five percent of overall pharmacy spending, but are expected to grow as biotechnology and genomic drugs become more readily available and commonly used, Aon added.

Randy Vogenberg, senior vice president with Aon Consulting�s Life Sciences practice, said, �Specialty pharmacy is an increasingly important issue for employers, due to our aging workforce and the ongoing development of advanced drugs for diseases such as depression, Alzheimer�s, Parkinson�s and cancer. These drugs offer significant advances in treating rare diseases and increasingly common disorders; but they are currently very costly due to lack of generic competition and inconsistent benefit plans across managed care organizations. Because drug development continues at a fast pace, it�s a complex task to forecast the increasing costs.�

Vogenberg advised, �Employers should look to implement cost management strategies for dealing with rising specialty pharmacy costs. Potential solutions include use of specialty prescription brand managers (PBM) and coordination with health plans, the use of evidence-based medicine to guide diagnosis and treatment, and analysis of claims and other data using economic models for proactive plan strategy.�
More...

Posted by: Duncan Kinder on Jun 14, 05 | 2:59 pm | Profile

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Lipitor, Zocor Head List of Top 10 Best-Selling Drugs

Anti-cholesterol drugs, Lipitor and Zocor, headed the lists of top-ten best-selling drugs, according to Med Ad News.

The top ten were as follows:


Rank); Drug; Condition; Company

1): Lipitor; cholesterol; Pfizer

2): Zocor; cholesterol; Merck

3): Advair; asthma; GlaxoSmithKline

4): Norvasc; hypertension; Pfizer

5): Zyprexa; schizophrenia; Eli Lilly

6): Nexium; acid reflux; AstraZeneca

7): Procrit; anemia; Johnson & Johnson

8): Zoloft ; depression; Pfizer

9): Effexor; depression; Wyeth

10): Plavix; heart disease; Bristol-Myers Squibb

Posted by: Duncan Kinder on Jun 14, 05 | 10:05 am | Profile

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Mon Jun 13, 2005

Blue Cross: Proposed Federal Association Health Plan Legislation Undermines State Protections

The federal Small Business Health Fairness Act of 2005, intended to make it easier for small businesses to purchase group health insurance, may actually serve to strip consumers of their current state law protections, according to Blue Cross and Blue Shield.

The federal act, introduced in the Senate as S.406 and in the House as H.R.525, attempt to allow small businesses to purchase group health plans through associations. This is intended to make it easier for small businesses to obtain insurance.

However, these federally approved association health plans would also be immune from state laws, many of which provide consumer protections.

According to Blue Cross, states have enacted laws to provide for fair insurance premiums, access to appropriate health care, and protection from fraud and abuse.

However, under the proposed law, all association health plans, rather than being regulated by the states, would be regulated by the U.S. Department of Labor instead. According to Blue Cross, DOL oversight would be "minimal."

According to Blue Cross, current state protections include:

. Limits on boosting premiums when employees get sick;
. Access to independent review panels when claims are denied;
. Mandatory benefits, such as mammography, child care, mental health services, and diabetes supplies;
. Prompt payment for physicians and hospitals; and
. Protection against plan failures.

Blue Cross cited Congressional Budget office reports that this legislation would cause premiums to increase for 75 percent of workers in small firms and that 10,000 of the sickest workers would loose coverage altogether.

According to Blue Cross, the following state law protections now exist:

Fair Insurance Premiums
. Insurers must limit how much they charge sicker groups: 49 states
Ensure Access to Independent Review
. Independent external review of claims denials: 44 states
Ensure Appropriate Access to Care
. coverage for emergency services: 45 states
. direct access to OB/GYNs: 42 states
. cover clinical trials: 20 states
Marketing Protections
. detailed requirements for marketing materials: 51 states
Mandatory Benefits
. mammography screening: 50 states
. minimum mastectomy stays: 22 states
. colorectal cancer screening: 19 states
. cervical cancer screening: 28 states
. well-child care 32 states
. mental health parity that exceeds federal requirements: 32 states
. diabetes supplies and education 47 states
. prompt payment rules 51 states
Oversight of Insurers
. handles consumer and provider complaints: 51 states
. investigation, oversight, and enforcement of rules: 51 states
Prevent Plan Failures and Ensure Claims Payment
. insurers required to maintain surplus: 51 states
. corrective action if insurer nears minimum standards: 51 states
. state quickly seizes assets to pay claims 51 states
Promote Access for the Uninsured
. mini-COBRA rules for employers of fewer than 20 40 states
. insurers help fund state high-risk pools 28 states

This count includes the District of Columbia. Under the proposed federal act self-funded but not fully-insured association health plans would be exempt from state prompt-pay laws. Self-funded plans also would be exempt from state solvency standards and instead be subject to looser federal standards

Posted by: Duncan Kinder on Jun 13, 05 | 4:05 pm | Profile

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LA Times: Grading Doctors May Make Them Avoid Risky Patients

When doctors are graded according to their outcomes, they may respond by avoiding seriously sick patients, according to an article in the Los Angeles Times.

The paper cites two recent studies. The first, by the University of Michigan, states that New York doctors, whose results are reported, are less likely to perform angioplasties than their Michigan counterparts, who are not. The second states that New York doctors, because of public reporting, are less likely to treat very sick patients. More...

Posted by: Duncan Kinder on Jun 13, 05 | 11:19 am | Profile

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Fri Jun 10, 2005

New Hampshire Creates Pre-Trial Screening Panel for Medical Malpractice Claims

New Hampshire, copying a system now used by Maine, on June 8 established a three-member panel to screen medical malpractice lawsuits to see if they may be frivolous.

SB 214, the legislation establishing this panel , states, "Presentation of claims to a medical review panel is intended to help identify both meritorious and non-meritorious claims without the delay and expense of a court trial."

"If the panel finds that a claim has merit, the defendant will be more likely to pay the claim or negotiate a compromise that is favorable to the claimant. If the panel finds that the claim lacks merit, the claimant is more likely to withdraw the claim or accept a nominal settlement," it adds.

Posted by: Duncan Kinder on Jun 10, 05 | 3:16 pm | Profile

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Study: Proposed State Medicaid Cuts Would Harm Pennsylvania's Hospitals

Pennsylvania's Hospitals would suffer serious financial setbacks if proposed cuts in the state's Medicaid budget are imposed, according to a study conducted by the Lewin Group.

Among the key findings from the Lewin study:

-- Pennsylvania ranks 30th nationally in Medicaid hospital spending, despite being ranked 4th highest nationally in total Medicaid spending and 6th highest in per enrollee expenditures.

-- Medicaid payment-to-cost ratios are 74.9 cents per dollar of care provided, and could fall to 67.4 cents under the proposed budget.

-- The proposed budget will have a $330 million impact on hospitals and the health care system.

-- If the state Medicaid budget is enacted as originally proposed, hospital total margins could fall from 3.1 percent to 1.9 percent.

-- Under the proposed state budget, the percentage of Pennsylvania hospitals with negative operating margins could rise to 55 percent - well above historic levels.

-- Making up for the proposed hospital Medicaid cuts would require a 3.1 percent increase in private insurance reimbursements - which would further increase the upward pressure on escalating health insurance premiums.

Posted by: Duncan Kinder on Jun 10, 05 | 2:51 pm | Profile

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Employers Shift CoPay Costs to Employees

According to a report issued by Hewitt Associates, employers are shifting copay costs for office visits, drugs, and emergency rooms to employees.

While the number of companies offering $20 office copays increased from 16 percent in 2004 to 25 percent in 2005, the percentage of employers offering $10 office copays has decreased from 29 percent in 2004 to 22 percent in 2005, it states.

The report cites widespread increased in drug copays.

The number of employers who require copays of greater than $50 for ER visits has increased 26 percent since 2001, it adds.

As a result, the rise HMO costs for employers rose at a lower level this year. The report did not cite how overall medical costs for both employers and employees may be faring, however.

Posted by: Duncan Kinder on Jun 10, 05 | 11:04 am | Profile

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Thu Jun 09, 2005

Alaska Caps Medical Malpractice Recoveries

Alaska governor Frank H. Murkowski signed into law a bill that limits non-economic recovery in medical malpractice suits to $250,000 generally and $400,000 in special cases.

The allows full recovery for economic losess, which it defines as "objectively verifiable monetary losses." It also excludes entirely hedonic damages, which it defines as the "attempt to compensate for the pleasure of being alive."

Generally, it caps non-economic losses at $250,000. However, "when damages are awarded for wrongful death or severe permanent physical impairment that is more than 70 percent disabling," it caps non-economic losses at $400,000.

These capped, non-economic losses include " compensation for pain, suffering, inconvenience, physical impairment, disfigurement, loss of enjoyment of life, loss of consortium, and other nonpecuniary damage."

These caps do not apply in instances or reckless or intentional misconduct.

Posted by: Duncan Kinder on Jun 09, 05 | 11:15 am | Profile

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Canadian Supreme Court Strikes Down Quebec Medical Plan

The Canadian Supreme Court has ruled today that Quebec cannot prohibit individuals from privately paying for medical treatment that the public system also covers.

Presently, in Canada, while patients may privately pay for services not generally offered under Canada's medicare system, they are barred from paying for those services that it does offer.

This ban was challenged by a patient who had to wait a year for a hip replacement operation and by a doctor who wanted to charge for services in a private hospital.

The ruling directly applies only to Quebec's plan and not to Canada's as a whole. However, because other provinces have plans that resemble Quebec's, the ruling probably will have widespread impact.

Posted by: Duncan Kinder on Jun 09, 05 | 11:15 am | Profile

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Telemedicine: Worldwide Service for Retiring Boomers

According to Forbes, as boomers retire to remote locations such as Costa Rica and Croatia, they will access healthcare remotely through telemedicine.

According to Forbes, digital clinics are already being built to service worldwide travelers.

Physicians also are experimenting with robots that would allow them to perform long distance procedures, including cardiac catheterization.
More...

Posted by: Duncan Kinder on Jun 09, 05 | 11:15 am | Profile

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Wed Jun 08, 2005

Health Care Costs Cause GM to Layoff Workers

Yesterday, General Motors announced that it would layoff 25,000 workers. Healthcare costs totaling nearly $6 billion annually or $1,500 per vehicle were a major cause of this layoff.

The Economist discusses how these costs are hurting General Motors and will probably cause the company to confront the United Auto Workers.
More...

Posted by: Duncan Kinder on Jun 08, 05 | 5:06 pm | Profile

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Paying for the Uninsured: It Probably Cost You $922 This Year

The unpaid expenses of the uninsured will cost, on average, $922 in added premium for employer-provided healthcare in 2005, according to a report issued by Families USA. It added that these added premium costs would rise to $1,502 by 2010.

In other words, one of every twelve dollars spent for employees' healthcare actually pays instead for the uninsured's healthcare, it states.

According to the report, health insurance premiums for family coverage in six states will be, on average, at least $1,500 higher in 2005 due to the unpaid cost of health care for the uninsured. These are New Mexico ($1,875); West Virginia ($1,796); Oklahoma ($1,781); Montana ($1,578); Texas ($1,551); and Arkansas ($1,514).

By 2010, the report states, eleven states will have those premiums, on average, $2,000 higher: New Mexico ($3,169); West Virginia ($2,940); Oklahoma ($2,911); Texas ($2,786); Arkansas ($2,748); Florida ($2,248); Alaska ($2,248); Montana ($2,190); Idaho ($2,152); Washington ($2,144); and Arizona ($2,028).

According to the report, only approximately one-third (35 percent) of the health care costs incurred by uninsured people is paid by them. The rest, (64 percent) is shifted to the insured, and added to the insured's premiums.

This shifted cost - the amount the uninsured do not pay for their health care which the insured instead must pick up - will exceed $43 billion nationally in 2005. In eleven states this cost will exceed $1 billion: California ($5.8 billion); Texas ($4.6 billion); Florida ($2.9 billion); New York ($2.7 billion); Illinois ($1.8 billion); Ohio ($1.4 billion); Pennsylvania ($1.4 billion); North Carolina ($1.3 billion); Georgia ($1.3 billion); New Jersey ($1.2 billion); and Michigan ($1.1 billion).

The Families USA report was based on data compiled by Dr. Kenneth Thorpe, Robert W. Woodruff Professor and Chair of the Department of Health Policy and Management, Rollins School of Public Health, Emory University, and the data are derived from the U.S. Census Bureau, the federal Agency for Healthcare Research and Quality, the National Center for Health Statistics, and other sources.

Families USA is a non-profit advocate group for health care consumers.

More...

Posted by: Duncan Kinder on Jun 08, 05 | 11:37 am | Profile

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Tue Jun 07, 2005

In Massachusetts, like Canada, You Must Wait to See Specialists

The next time someone tells you the Canadian medical system is flawed because patients there are on waiting lists to receive treatment, tell them to keep away from Massachusetts, because there patients seeking help from five specialties must wait three to five weeks, according to a study by the Massachusetts Medical Society .

The waiting periods are for cardiology, gastroenterology, internal medicine, obstetrics-gynecology, and orthopedic surgery, the Society states. Two week, it says, would be the typical waiting period for a busy practice.

The study also states that the number of patients who find getting a physician to be "extremely difficult" has soared in 2005 to 15 percent from 9 percent in 2004 and 7 percent in 2003. The top two obstacles patients cited were high cost and difficulty in finding a doctor or obtaining an appointment. The lower a patient's income and the less his education, the more likely he would face difficulties, the study stated.

While the Society also reports a growing doctor shortage, the overlap between those specialties with waiting periods, one the one hand, and those experiencing shortages, on the other, is not great. The society states three specialties -- neurosurgery, anesthesiology, and radiology -- to be in �critical� shortage and three others --gastroenterology, cardiology, and orthopedics -- in �severe� shortage. Only three specialties, gastroenterology, orthopedics and cardiology, are on both lists. Apparently something else is causing waiting periods for internal medicine and obstetrics-gynecology. Why doctor shortages in neurosurgery, anesthesiology, and radiology fail to cause waiting periods is also unclear.

Whatever the relationship between doctor shortages and waiting periods, the Society said that Massachusetts' "unfriendly" practice environment caused doctors to leave. High medical liability costs were the greatest reason why that environment was unfriendly, it added.

Posted by: Duncan Kinder on Jun 07, 05 | 3:34 pm | Profile

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California Single-Payer Bill Passes State Senate

California's state senate on May 31, by 25 ayes to 15 noes, approved SB 840, which would require California to adopt a statewide universal single-payer health plan. The bill is now before the state assembly.

Introduced by state Senator Sheila Kuehl (Democrat, Los Angeles), the bill would both make all Californians eligible for specified health care benefits and also prohibit insurers from providing those same benefits.

According to the Bill's Legislative Digest , existing California does not now provide universal coverage in the state. Instead, it has several programs for special groups. These include the Healthy Families Program and the MediCal program.

Presently, the state's Department of Managed Health Care regulates health service plans while its Department of Insurance regulates its insurers.

SB 840 would instead create a California Health Insurance System. A new California Health Insurance Agency would administer it, while a new, elected state Health Insurance Commissioner would control the new agency.

All California residents would eligible for the system's benefits.

The system would be single-payer. It would negotiate for or set fees for services provided through its system and would pay claims for those services.

The system would have to be operational within two years of the bill's enactment.

The bill would require the commissioner to take steps to have various federal, state, and local health care payments be made to the new system. The system would then assume responsibility for benefits and services that these funds previously paid.

Other new positions created by the bill would include:
. a health insurance policy board to establish policy on medical issues and other matters,
. an Office of Consumer Advocacy to represent the interests of consumers,
. Office of Health Care Planning to plan for future health care needs,
. an Office of Health Care Quality to promote heath care quality and consumer satisfaction,
. an Office of Inspector General for the system with oversight powers,
. and a Health Insurance Fund and Payments Board to administer the system's finances.

Insurers could not provide policies or service plan contracts for services the system would cover. Nor could participating companies pay shareholder dividends from systems revenues.

The bill would extend insurance fraud laws to the system's service and product providers.

It also includes other provisions, including reimbursement to local agencies and school districts for mandated costs.



Posted by: Duncan Kinder on Jun 07, 05 | 1:13 pm | Profile

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Mon Jun 06, 2005

Telemedicine: The Doctor is Literally on Call

Today, doctors in Singapore are treating patients in Jakarta through electronic teleconferencing. Tomorrow, they could be treating you.

Using telemedicine, doctors can even use electronic stethoscopes to hear a patient's heartbeat.

Doctors in the United States today already use telemedicine. Prison health systems first developed it in order to connect doctors, who did not want to enter the prisons, with prisoners, who could not leave.

Specialists also use telemedicine to deliver care to rural areas. This saves patients the need to travel for treatment.

But doctors in Singapore see something new for telemedicine. It can eliminate boundaries between countries.

Through medical tourism, patients seeking lower cost health care already are traveling to Singapore and neighboring countries.

Singapore doctors could use telemedicine to prepare a diagnostic treatment plan before they travel to Singapore. More...

Posted by: Duncan Kinder on Jun 06, 05 | 3:33 pm | Profile

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Passengers Flying to Surgery Destinations Risk Fatal Blood Clots

The prolonged immobility of airline passengers increases the risk of blood clots, which could be fatal before major surgery, according to Mayo Clinic Proceedings.

This risk could be important for would-be medical tourists.

Medical tourism is a growing trend in which American and European patients, seeking lower medical costs, travel to countries such as India, Singapore, and Thailand for treatment.

According to Mayo, it studied patients who had flown more than 5,000 kilometers on their way to major surgery. It found eleven cases where patients had had blood clots within twenty-eight days of surgery.

According to Mayo, long-haul travelers had a greater blood clot rate. Those who had clots were younger, developed clots earlier, were healthier, but also were more likely to smoke. According ot Mayo, it studied passengers who had traveled more. Ten of the eleven were from the Middle East.

Patients who fly long distances before surgery should have greater treatment for potential blood clots, Mayo added.

Update: Thomas Cook Travel Agency has information about this.

Posted by: Duncan Kinder on Jun 06, 05 | 3:12 pm | Profile

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Artists Die of Consumption? It Might not Just be Out of La Boheme

Comment: In Puccinis' opera, La Boheme, the heroine, a poor artist, dies of consumption. Under the modern American health system, such a fate for an artist would not be as farfetched as one might think, for it is very difficult, nowadays, for struggling artists to get medical insurance.

The opera, La Boheme, describes the lives of struggling young artists in nineteenth century Paris. The heroine, Mimi, has tuberculosis, from which she dies in the end.

While such a life might be tragic and somehow glamorous for nineteenth century France, it is too close for comfort for twenty-first century America. Nevertheless, being self-employed, getting medical insurance is no small feat for today's struggling artists.

One such experience has been related by John Kolstad, now president of a music distribution business.

Kolstad says that, after graduating from college in the 1960's, he toured as a musician for two-and-one-half years. During that time, he could not afford medical insurance. Instead, he used emergency rooms and free clinics.

He finds it interesting to hear talk about how important music and the arts are when our society has a health care system that leaves artists and musicians out in the cold, he adds.

Unlike Mimi, Kolstad today is alive and well. But may be because he left his bohemian troubadour existence in order to found a business, through which he could obtain insurance.

Perhaps the world is better off today because Kolstad is now a businessman and no longer an artist. Perhaps, indeed, he would have been a forgettable artist while he has contributed much through his business instead.

But we don't know this. And in today's world, Kolstad had little choice.

Posted by: Duncan Kinder on Jun 06, 05 | 2:41 pm | Profile

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Sat Jun 04, 2005

Import Drugs From Canada? Not if These Canadians Can Help It

While many in the United States believe importing drugs from Canada to be a solution for the United States' drug problem; many in Canada believe exporting drugs to the United States to be a problem for Canada's drug problem.

Canadian doctors and pharmacists oppose United States' bulk importing inexpensive Canadian drugs because, they say, these imports would cause problems in Canada, according to the Toronto Globe and Mail.

Canada would suffer drug shortages, price increases, and reduce the number of professionals who could fill prescriptions for Canadians themselves, it states.

Drugs in Canada, unlike the United States, are price regulated. Therefore they generally are less expensive there. Currently importing Canadian drugs is illegal. Therefore, many in the United States want to change the law to legalize Canadian drug imports.

Canada's population is about 32 million while the United States' is about 250 million. Canada would be too small to handle widespread drug demand from the United States, Canadian opponents of drug exports told the paper.

Reportedly, Canada is already short 2,000 pharmacists. Serving an additional 250 million Americans would make this shortage worse, it adds.

According to the paper, 56 percent of Canadians are concerned about United States drug import initiatives while 73 per cent want regulations to remove the incentive for other countries to buy our medicines.

Posted by: Duncan Kinder on Jun 04, 05 | 5:09 pm | Profile

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Fri Jun 03, 2005

Illinois: Malpractice Legislation Awaits Governor's Signature

The Illinois legislature has approved legislation that limits non-economic damages from malpractice lawsuits at $1 million for hospitals and $500,000 for doctors.

Other proposed changes include requiring expert witnesses to be in the same specialty as the physician-defendant, excluding a doctor's apology for a medical outcome from being used against him at trial, and protections for retired physicians who volunteer at free medical clinics.

Posted by: Duncan Kinder on Jun 03, 05 | 4:19 pm | Profile

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L. A. Times: California "Getting Dangerously Close to a Tipping Point" Where Employers No Longer Provide Health Benefits

California is in a downward spiral in healthcare coverage in which fewer and fewer employers provide healthcare benefits, according to a study reported in the Los Angeles Times. As a result, the number of uninsured Californians will grow 20 percent over the next five years. This trend will likely spread throughout the entire United States.

The UC Berkeley Center for Labor Research and Education and by Working Partnerships, USA, a union-affiliated non-profit conducted the study.

According to the study, lower and middle-income Californians will be most affected. From 2000 to 2004, the percentage of full-time working Californians earning between $9 and $11 per hour who had employer-provide medical insurance dropped from more than 59 percent to 46 percent. (Nationally, the percentage dropped from 64 percent to 58 percent during this same period.)

Uninsured people, who, lacking preventive medicine, develop serious illnesses, and who turn to expensive emergency rooms for care, cost more than the insured. Therefore, the more uninsured there are, the greater the overall health costs. However, because the uninsured cannot afford to pay for their care, the insured must pick up these costs. This leads to higher insurance rates, which in turn lead to more people becoming uninsured.

This is the "downward spiral" quoted by the Times.

The $9 per hour jobs are the very ones being added most quickly, the paper states.

Reportedly, California is five years ahead of the rest of the United States in this downward trend. More...

Posted by: Duncan Kinder on Jun 03, 05 | 3:23 pm | Profile

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North Carolina: Blue Cross Non-Profit Status Challenged

Three bills before the North Carolina legislature are challenging Blue Cross and Blue Shield of North Carolina's non-profit status, according tothe Charlotte News Observer.

Blue Cross, which is non-profit, nevertheless earned more than $350 million in 2003 and 2004, the paper states.

Blue Cross reportedly also sponsored a Caribbean island getaway for 275 top sales staff and health-insurance brokers in February. The four-night trip to St. Kitts probably cost Blue Cross at least $600,000, the paper states.

One bill would seize $250 million of Blue Cross' reserves and use it for the uninsured. The second would direct the state's department of insurance to look at Blue Cross profit profile; while the third would let regulators consider Blue Cross profits when approving premium increases.

According to the paper, all three bills face difficulties in getting passed. More...

Posted by: Duncan Kinder on Jun 03, 05 | 3:23 pm | Profile

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Electronic Medical Records: Big Brother or Better Medicine?

The American medical system is endangering lives because of its sloth in adopting electronic health records, according to former House Speaker Newt Gingrich.

However, the Australian medical system poses grave privacy risks because of its rush to computerize everyone's medical records, according to the Sydney Morning Herald.

Gingrich now heads an advocacy group, the Center for health Transformation. Recently, he joined Senator Hillary Clinton in supporting legislation intended to advance electronic health records in the United States.

Reportedly, the rate American medicine is moving toward computerized records is slow. While the United States has yet to develop its health information technology strategy, Australia has already released a detailed strategy to deploy a nationwide system over the next four years.

Reportedly, Gingrich stated that patients die because their health records are currently unavailable. To solve this, he said that the medical system should use the same record-keeping systems now used in other sectors of the economy.

Medical safety standards should match aviation safety standards, he added.

Others dispute whether computerizing medical records promotes safety. Reportedly, a study in the Archives of Internal Medicine found adverse reactions to prescription drugs caused by medical errors are "about as common in computerized setting as in noncomputerized ones"

Another advocate of computerized medical records, HHS Secretary Mike Leavitt, cites lower costs as well as fewer risks as reason for them.

Australia's rapid pace toward computerized records has provoked criticism. According to the Morning Herald, Australia's new plan is involuntary - Australians would no longer be able to choose whether their own records would be computerized. A voluntary system would be too expensive, it adds.

"This still means certain people, such as the NSW premier - who already has powers to access health records - could in theory have access to any patient's health record," it states.

According to the paper, there already have been examples of people's privacy being breached.

Posted by: Duncan Kinder on Jun 03, 05 | 2:01 pm | Profile

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Thu Jun 02, 2005

Is Tort Reform Causing Doctors to Migrate?

Doctors are migrating to states that have enacted caps on medical malpractice reforms, according to the journal, Health Affairs; while the Journal of American Medical Association's study, finds little evidence that doctors are leaving one state for another with a more favorable liability climate.

Apparently, at issue is whether the growth of doctors since the 1980's in tort reform states has exceeded those in non tort reform states by 3 percent or 19 percent.

According to Health Affairs, the number of doctors increased 83 percent in states that had no cap on noneconomic damages. For states that had enacted caps in the 1970's, the growth rate was slightly higher, 86 percent; but those states that had enacted them in the 1980's, the growth rate was 102 percent.

In contrast, the Journal of the American Medical Association found that the supply of doctors increased throughout the nation between 1985 and 2001. Non tort reform state growth exceeded tort reform state growth by only 3 percent.. More...

Posted by: Duncan Kinder on Jun 02, 05 | 9:18 am | Profile

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Pharmaceutical Companies, Seeking to Cut Costs, Outsource R&D; to Asia

Because of cost cutting, 40 percent of pharmaceutical R&D;, worth more than $60 billion this, year is being outsourced, according to Drug Discovery & Development.

Much of this outsourcing is heading toward Asia and the Pacific, according to an IBC Life Sciences press release.

"U.S. and European companies are partnering with Asian counterparts as pharmaceutical and biotech leaders recognize that investment in the region allows them to forge new scientific alliances while reducing drug development costs, � it states.

"Asia Pacific offers a significant value proposition to large pharmaceutical companies," says Nigel Sheail, vice president for Global Head Licensing at Hoffmann La Roche, Inc., USA..

"A second wave is building with players actively seeking strategic alliances and partnership opportunities globally across the R&D; value chain," says Lorenz Ng, M.D., vice president for Research Alliances and Business Development for Eli Lily Asia, Inc., China.

According to Drug Discovery and Development, some biotech and pharmaceutical companies are becoming near "virtual" organizations. A company can be more a "search and development company" than a "true R&D; group."
More...

Posted by: Duncan Kinder on Jun 02, 05 | 9:18 am | Profile

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Vermont Universal Coverage Reform: Governor Threatens Veto

Vermont Governor James Douglas has threatened to veto proposed state-level universal coverage reform legislation if it contains proposed payroll tax provisions.

Both houses of the Vermont legislature have recently approved tax reform legislation apparently intended to provide universal health coverage for all Vermonters. House and Senate bills differ; the House version is considered the more sweeping. Legislators and Governor Douglas are now negotiating over the bill.

One proposed means to fund the reform is a payroll tax.

According to Douglas, the legislators' plan would ultimately lead to a government-run health system into which all taxpayers would have to pay. He stated the legislation's proposed payroll tax would rise over the next four years.

According to House and Senate leaders, they are committed to the payroll tax, which they say would apply to the uninsured and their employers. They said Douglas was misrepresenting their intentions.
More...

Posted by: Duncan Kinder on Jun 02, 05 | 9:18 am | Profile

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Wed Jun 01, 2005

Employee Health Costs Bust Municipal Budgets

As insurance rates soar as much as 30 percent, local governments are facing budget difficulties in continuing to provide health benefits to their employees.

Reportedly, local government work forces age more than other work forces because workers tend to stay longer. This means they have greater overall health costs.

Local governments are attempting to persuade their workers to accept health plans with fewer benefits or with higher deductibles, reports state.
More...

Posted by: Duncan Kinder on Jun 01, 05 | 11:21 am | Profile

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Employers are beginning to monitor their employees' lifestyles in order to cut health costs.

Employers are beginning to monitor their employees' lifestyles in order to cut health costs, according to the Chicago Tribune.

Using a new science called "predictive modeling," employers are analyzing claims data and information they collect from their employees about their lifestyles to find out why some workers develop high claims rates, the Tribune states.

Employers' per worker health costs have soared 80 percent since 2000, it adds.

Apparently, by using predictive modeling, employers are seeking more detailed information than just whether a worker may smoke or may be overweight.

According to the Tribune, computers can generate health profiles that look like weather maps, turning from blue to red-orange when health risks increase.

Using "health risk assessments," computers can sort workers into high, medium, and low risk categories, it adds.

According to the Tribune, privacy experts believe this new monitoring is intrusive. However, it also quotes others as believing that it can lead to earlier health interventions.
More...

Posted by: Duncan Kinder on Jun 01, 05 | 10:14 am | Profile

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Medical Insurers Now Seek the Uninsured - If They're Healthy

Medical insurers are viewing the presently uninsured as a new market, as insurance sales to businesses stagnate, the Pittsburgh Post-Gazette reports.

According to the Post-Gazette, many of the presently uninsured were formerly insured through employer group health benefits. Now fewer employers offer those benefits. Many of them are "relatively healthy," the Post-Gazette states.

These uninsured do not want the generous but expensive individual insurance plans now offered, the Post-Gazette adds. Therefore, to lure them, insurers are offering new, low-cost plans with fewer benefits.

Groups insurers want to attract include young adults; part-timers, temporary workers and early retirees; and the middle class. More...

Posted by: Duncan Kinder on Jun 01, 05 | 12:26 am | Profile

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